Registered nurses' understanding of truth-telling as practiced in the nursing-home: an Australian perspective.

ABSTRACT

This article draws on an Australian research study using multiple qualitative methods to investigate 'truth-telling' in aged-care. Registered nurses understand truth-telling to be an instrumental practice in which information should be used as a means to avoid harm. The worth of truthfulness is therefore measured by its outcome(s). Truth-telling in nursing practice in the aged-care setting is primarily partial, edited, and stratal, and premised on 'easing' (harm avoidance) and 'omitting' (omission of detail). Moreover, truth-telling is premised on the view that residents' families will be harmed by full disclosure and do not want, or need, bad news. Truth-telling in practice, underpinned by benevolent protectionism, means that non-disclosure aims to reduce the burden of harm(s). The practice of truth-omission however, contrasts with findings from other studies which suggest full-disclosure is beneficial to both patients and their relatives.

KEY WORDS

Truth-telling; nurse; nursinghome; aged-care; constructionism; sociology

Introduction

This paper reports on one aspect of a much larger qualitative study which explores the meaning of 'truth-telling' within the care provider-older person dyad in high-level (nursinghome) aged-care. In this part of the study, the focus is on registered nurses' understandings of their truth-telling practices in the nursing-home. It shows that nurses understand truth-telling as instrumental, and should be used in a manner that avoids harm to patients and their families. This conflicts with findings elsewhere in the literature which suggest full disclosure is beneficial.

Truth-telling, lies, and partial disclosure